Who Gets Dissociative Identity Disorder
While there is no specific roadmap of who gets this disorder, statistics show that around 90 percent of people with dissociative identity disorder have a past history of childhood neglect and abuse. And these numbers are not just from the United States but Canada and Europe too.
Dissociative identity disorder has related conditions that have trauma as a cause, such as:
What To Do If You’re Worried About Someone
If you’re worried that someone you know may be considering suicide, try to encourage them to talk about how they’re feeling.
Listening is the best way to help. Try to avoid offering solutions and try not to judge.
If they have previously been diagnosed with a mental health condition, such as depression, you can speak to a member of their care team for help and advice.
The Different Therapeutic Interventions Available In The Management Of Dissociative Disorders
A broad overview of the treatment of dissociative disorders is outlined in Figure 1. Based on the type of dissociative disorder, the choice is shown in Figure 2.
Choice of therapy based on type of disorder
In order to decide the form of therapy needed in dissociative states, it is important to understand the possible genesis of dissociation .
A few techniques which may be practised while managing the patient are as follows.
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What Is The Outlook For People With Dissociative Amnesia
For most people with dissociative amnesia, memory eventually returns, sometimes slowly and sometimes suddenly, which makes the overall outlook very good. In some cases, however, the person is never able to fully recover their lost memories.
To improve a persons outlook, its important to treat any dissociative amnesia problem as soon as possible. It is also important to treat any other problems or complications, such as depression, anxiety or substance abuse.
Types Of Dissociative Identity Disorder Treatment
Reviewed by Whitney White, MS CMHC, NCC., LPC
Dissociative identity disorder is a mental illness that can cause significant life impairment and distress. Once called multiple personality disorder, this mental condition is usually severe. Fortunately, if you have it, you can receive excellent care and treatment to decrease your symptoms and help you live a productive, fulfilling life. Heres a look at the treatments available and how they work.
Treatment Starts with Diagnosis
The first stage of treating dissociative identity disorder is diagnosis and assessment. Even before that, youll have to have some indication that you need to seek help. The entire first stage can happen fairly quickly, but you cant solve this problem at all until you get started.
Screening for DID
Seeking help for DID is a big step. You might be hesitant to start the process if you arent sure you really have the signs of the disorder. But theres a way to get an objective rating of your symptoms. You can take a screening testfor dissociative personality disorder. After a few brief moments, you get an assessment of symptoms. Its important to note that this screening tool isnt a diagnostic test and is just meant to help you identify symptoms.
Diagnosis of Dissociative Identity Disorder
Distinct Identities
Changes Due to Identity Shifts
Memory Gaps
Impairment and Distress
Assessing Symptoms
Treatment Goals
Types of Treatment
Phase-Oriented DID Therapy
Phase 1
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How Can I Help Someone With Delusional Disorder
If you know someone with delusional disorder, you can help by providing support and encouragement for them to seek help and treatment.
People with delusional disorder who feel pressured or repeatedly criticized by others will likely experience stress, which may worsen their symptoms. Because of this, a positive approach may be more helpful and effective.
The friends and family members of people with delusional disorder often experience stress, depression, grief and isolation. Its important to take care of your mental health and seek help if youre experiencing these symptoms.
A note from Cleveland Clinic
Its important to remember that delusional disorder is a mental health condition. As with all mental health conditions, seeking help as soon as symptoms appear can help decrease the disruptions to life. Mental health professionals can offer treatment plans that can help manage thoughts and behaviors.
Addressing Separate Personality States
The biosocial theory of BPD serves both as a theoretical underpinning and an important clinical touchstone for the DBT treatment approach. Patients find it enormously helpful in understanding their condition, and clinicians turn to it for guidance with case formulation and treatment decisions. The treatment of DID is perhaps even more reliant on a central explanatory conceptsometimes referred to as the trauma model of DID . In this model, dissociation is seen as both a spontaneous reaction to trauma and a defense against overwhelming traumatic affects. We posit that when a child faces chronic trauma from an early age, her repeated experiences of traumatic dissociation can lead to the development of seemingly separate personality states separated by amnestic barriers. This concept is essential in helping the patient bring together bafflingly disconnected pieces of her experience, as well as framing them in a sympathetic light. For the therapist, the fundamental understanding that patients with DID have dissociated in response to overwhelming traumatic affects, and that the personality structure is based on avoiding these affects, informs all clinical decisions.
First, the therapist persistently urges the patient to improve communication with other parts of herself. The therapist might suggest that the patient ask inside, or use other techniques, such as journaling or the dissociative table technique to gradually improve internal communication.
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What Are The Symptoms Of Dissociative Identity Disorder
The most recognizable symptom of dissociative identity disorder is a persons identity being involuntarily split between at least two distinct identities . Other symptoms might include:
- Dissociative amnesia. This is a type of memory loss beyond forgetfulness thats not associated with a medical condition.
- Dissociative fugue. A dissociative fugue is an episode of amnesia that involves not having memory of certain personal information. It may include wandering off or a detachment from emotion.
- Blurred identity. This occurs when you feel like there are two or more people talking or living in your head. You might even feel like youre possessed by one of several other identities.
Its important to note that according to the Diagnostic and Statistical Manual of Mental Disorders, many cultures around the globe include possession as part of a normal spiritual ritual or practice. This isnt considered a dissociative disorder.
What Are The Signs And Symptoms Of Did
A person with DID has two or more distinct identities. The core identity is the persons usual personality. Alters are the persons alternate personalities. Some people with DID have up to 100 alters.
Alters tend to be very different from one another. The identities might have different genders, ethnicities, interests and ways of interacting with their environments.
Other common signs and symptoms of DID can include:
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Symptoms Of A Dissociative Disorder
Symptoms of dissociative disorder can vary but may include:
- feeling disconnected from yourself and the world around you
- forgetting about certain time periods, events and personal information
- feeling uncertain about who you are
- having multiple distinct identities
- feeling little or no physical pain
Dissociation is a way the mind copes with too much stress.
Periods of dissociation can last for a relatively short time or for much longer .
It can sometimes last for years, but usually if a person has other dissociative disorders.
Many people with a dissociative disorder have had a traumatic event during childhood.
They may dissociate and avoid dealing with it as a way of coping with it.
Interacting With Someone With Dissociative Identity Disorder
If you believe someone you know has DID, you may get the impression that youre communicating with not one, but several different people, as the person switches between personalities.
Often, each identity will have their own name and characteristics. Theyll each commonly have an unrelated detailed background with obvious differences in age, gender, voice, and mannerisms. Some might even have individual physical characteristics such as a limp or poor vision that requires glasses.
There are often differences in each identitys awareness and relationship or lack thereof to the other identities.
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Taking A Dissociative Disorder Test
If you are concerned that you or someone you love has been experiencing symptoms of dissociative identity disorder or any other type of dissociation then it might be time to get an assessment from a professional. Prior to making an appointment you can begin by taking a self-assessment test or asking your loved one to do a screening test online. This will give you a better idea of whether the symptoms could potentially indicate a disorder.
These types of test are by no means a diagnosis and they are not a true clinical exam but merely a way to determine if a serious assessment by a psychiatrist is necessary. If you score high for having a dissociative disorder on the test then you should seek a medical professional to help you get an evaluation and diagnosis. Once you receive a diagnosis you can then take the steps towards getting treatment for the disorder and reducing symptoms with psychotherapy.
When Should I Call My Doctor About Did
If you or someone you know has DID and exhibits any of the following symptoms, seek medical attention right away:
- Suicidal thoughts.
- Violent behavior.
You can call the National Suicide Prevention Lifeline at 800.273.8255. This hotline connects you to a network of local crisis centers that provides free and confidential emotional support. The centers support people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. In an emergency, call 911.
A note from Cleveland Clinic
Dissociative identity disorder is a mental health condition. Someone with DID has multiple, distinct personalities. The various identities control a persons behavior at different times. The condition can cause memory loss, delusions or depression. DID is usually caused by past trauma. Therapy can help people manage their behaviors and reduce the frequency of identity switches. Its important for anyone with DID to have a strong support system. Healthcare providers, family members and friends can help people manage DID.
Last reviewed by a Cleveland Clinic medical professional on 05/25/2021.
References
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Is Hypnosis Used As The Sole Treatment
Hypnosis is usually used along with other therapies and treatments, as part of a complete total treatment plan. The decision to use hypnotherapy in a clinical setting as a sole treatment or as an add-on treatment in psychotherapy or traditional medicine is made in consultation with a qualified professional whos trained in the use and limitations of hypnotherapy.
Medication For Dissociative Identity Disorder
The core of treatment for DID is through plenty of psychotherapy sessions, but medication may also be used in some cases to help minimize symptoms. Many people with dissociative identity disorder have co-occurring symptoms that go along with their condition such as depression, anxiety, anger and impulse control problems.
These can be treated with various types of medication such as anti-depressants such citalopram or sertraline and anxiety medication such as Xanax and valium. For people with DID who have manic or violent behavior, depressants can be helpful in diminishing the hyperactivity of the brain and also prevent seizures which can sometimes occur with the disorder.
Issues with anger and impulse control can be minimized with anti-psychotic medication which can help tranquilize and stabilize the mood. While medication can help reduce some of these co-occurring symptoms, these should only be supplemental to co-occurring disorder treatment that is mainly focused on therapy.
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Who Is At Risk For Did
Research indicates that the cause of DID is likely a psychological response to interpersonal and environmental stresses, particularly during early childhood years when emotional neglect or abuse may interfere with personality development. As many as 99% of individuals who develop dissociative disorders have recognized personal histories of recurring, overpowering, and often life-threatening disturbances or traumas at a sensitive developmental stage of childhood .
Dissociation may also happen when there has been persistent neglect or emotional abuse, even when there has been no overt physical or sexual abuse. Findings show that in families where parents are frightening and unpredictable, the children may become dissociative. Studies indicate DID affects about 1% of the population.
If You’re Feeling Suicidal
If you have thoughts about taking your life, it’s important you ask someone for help.
It’s probably difficult for you to see it at this time, but you’re not alone or beyond help.
There are people you can talk to who want to help:
- speak to a friend, family member or someone you trust, as they may be able to help you calm down and find some breathing space
- call the Samaritans free 24-hour support service on 116 123
- go to your nearest A& E and tell the staff how you’re feeling
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How Dissociative Identity Disorder Is Treated
Treating dissociative identity disorder in stages is not a new idea. In fact, renowned French psychologist Pierre Janet advocated multi-stage treatment as early as the late 1800s. In the past three decades, however, support for phase-oriented psychotherapy has grown significantly and it has now become the gold standard for dissociative identity disorder treatment. The most common course of treatment consists of three stages:
What Is Dissociative Identity Disorder
This disorder has a specific characterization. It is when a person feels disconnected, as if that person wanted to escape from reality. But the escape is not voluntary. Instead, a persons memory, thoughts, consciousness, and reality are disconnected.
As defined in the Diagnostic and Statistical Manual of Mental Disorders , there are three kinds of dissociative disorders.
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How Common Is Depersonalization Disorder
Transient depersonalization/derealization is quite common. This situation occurs when you experience depersonalization symptoms briefly. You have a fleeting feeling of being detached from yourself or the environment. You may feel like youre watching yourself in a movie. Experts estimate it occurs in about half of the population.
It occurs in less than 2% of the population. Its rare for depersonalization/derealization to need treatment.
Treatment For Dissociative Identity Disorder Will Likely Consist Of Therapy And In Some Cases Medication Management
Living with dissociative identity disorder can be challenging, learning how to manage symptoms and maintain a routine may be overwhelming for someone diagnosed with DID but when you enter treatment for DID, it can help someone learn to manage their symptoms and develop coping mechanisms.
Treatment for dissociative identity disorder should only be conducted by a specially trained professional. Treatment for DID will likely consist of therapy and in some cases, medication management. While there are several approaches to treat DID, most treatment methods have the goal of reconnecting the patients multiple personalities into one identity. Some additional goals of treatment may include processing trauma and developing ways to cope with painful memories and new stressors.
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Therapy Options For Dissociative Identity Disorder
Therapy for dissociative identity disorder focuses on processing trauma so that all the personalities can be reintegrated. Psychotherapy is most likely to be conducted on an individual basis. In some cases, a clinician may use an approach like group therapy, in which they allow all of the personalities to engage in therapy together.
Types of therapy for dissociative identity disorder therapy may include:
- Eye Movement Desensitization and Reprocessing . This type of therapy was initially developed to alleviate the stress associated with traumatic events and memories. The focus of EDMR is to relieve distress, reformulate negative thoughts and reduce physiological arousal. During and EDMR session, the patient is exposed to emotionally disturbing content in brief, sequential doses while also being instructed to focus on external stimuli.
- Cognitive behavioral therapy . This kind of therapy is the most common type of therapy used by treatment providers. Developed originally to treat depression, CBT is used to treat several types of mental health disorders. During therapy, patients will learn healthy ways to manage stressful situations and difficult emotions by changing the way they think and correcting their behaviors.
- Dialectical behavioral therapy . Dialectical behavioral therapy is used to help patients examine their thoughts, opinions and reactions. During therapy, patients can learn how to change the way they respond to their internal signals.
Deterrence And Patient Education
Patient education must focus on informing patients on the correct diagnosis when it is determined. Family members are encouraged to be educated about the nature of this illness, including the presence of alters as well as safety and grounding techniques. Another vital aspect continues to maintain a strong therapeutic alliance with the treatment team and engage in maintaining safety techniques.
Education may be done with multiple alters that do not communicate with each other, and this must be recognized. On the other hand, DID patients often do not want their diagnosis shared publicly, and their privacy must be respected.
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Does Insurance Cover The Cost Of Hypnosis Treatment
Always contact your health insurance company before your appointment to ask if hypnotherapy is a covered benefit. Many insurance companies cover 50% to 80% of the cost of hypnotherapy if performed by a licensed medical professional.
A note from Cleveland Clinic
Hypnosis is a shift in consciousness that enables you to tap into core thoughts, emotions, perceptions, beliefs and with the guidance of a trained hypnotherapist to change your thinking pattern to better manage your health issue. Hypnotherapy isnt for everyone, but it might be helpful for you. It can be a powerful and successful add-on tool to other more traditional forms of mental health or medical therapy. If youre interested, be sure to ask your healthcare provider about hypnotherapy and for a hypnotherapist referral, if they dont provide this treatment tool.
Last reviewed by a Cleveland Clinic medical professional on 04/01/2022.
References